Our Hand, Wrist, & Elbow Specialties

Advanced Ortho and Spine’s Hand, Wrist, & Elbow program provides expertise in the care and treatment of hand, wrist, and elbow injuries and conditions. Our hand, wrist, and elbow experts offer the latest innovations in microvascular surgery, nerve injury, tendon lacerations, hand arthritis and fractures, trigger finger, wrist fractures and arthritis, elbow pain, carpal tunnel, and cubital tunnel treatment, and more. Find relief from hand, wrist, and elbow pain with our upper extremity team.

Want to learn about our shoulder and upper extremity specialties?

Microvascular Surgery

Microvascular surgery is an advanced technique allowing surgeons to operate on small blood vessels. Injuries of the hand, fingers, and wrist often require microvascular surgery. During microvascular procedures, the surgeon uses a surgical microscope and specialized instruments. With these tools, they can reconnect individual blood vessels, which are microscopic in size. Due to its complexity, microvascular surgery can only be performed by highly skilled surgeons with expertise and specialized training in the technique. Advanced Ortho and Spine is proud to provide microvascular surgery for a range of upper extremity conditions and issues.

Carpal Tunnel Syndrome

Carpal Tunnel Syndrome is thought to affect 1 in 5 people in the United States. Numbness, tingling, and weakness in the hand are all key indicators of Carpal Tunnel. Symptoms are most likely to affect the thumb, index, middle, and ring finger. These symptoms are caused by pressure on the median nerve. The median nerve runs down the arm from your elbow. It passes through the “carpal tunnel” in the wrist and ends in the hand. While not fatal, prolonged carpal tunnel syndrome without treatment can lead to loss of function of the hand and permanent damage to the nerves. Most patients try anti-inflammatory medication or wrist splints to relive the sensation. If these fail to relieve symptoms, patients may require steroid injections or surgery. During surgery, one of our upper extremity specialists makes a small incision in the palm. This allows them access to the ligament compressing the nerve. They then make a small cut in the ligament to relieve pressure on the nerve. This process is called surgical decompression.

Cubital Tunnel Syndrome

Cubital Tunnel Syndrome is similar to Carpal Tunnel Syndrome, though it affects a different nerve. The symptoms are similar with the characteristic numbness, tingling, and weakness in the hand. However, Cubital Tunnel is most likely to affect the little finger, ring finger, and inside the hand. This condition happens from compression of the ulnar nerve. The ulnar nerve runs from the neck to the hand. Compression usually occurs behind the inside part of the elbow around the “funny bone.” The first line of treatment is medication and an elbow splint. If these do not relieve symptoms, patients may have steroid injections or decompression surgery. During surgery, one of our upper extremity specialists makes a small incision in the elbow. Then, the surgeon makes a small cut in the ligament. This relieves pressure on the ulnar nerve, reducing symptoms.

Did you know we offer convenient onsite physical therapy?

Hand, Wrist, & Elbow Specialists


Dr. Erik Maryniw

Board-Certified Hand & Upper Extremity Surgeon,
Board-Certified Orthopaedic Surgeon

Want to learn more about our specialties and procedures?


Learn More on Our Blog.

Advanced Ortho and Spine offers patient-centered care, which includes patient education. Learn more about conditions, treatments, practice news, and more on our blog.

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Patient Testimonials

Dr. Cook recently replaced my right hip. He did the left 3 years ago. Love this doc! He is so professional and had an easy going bedside manner. He explains everything in understandable language. He even called me with MRI results when he was on vacation. The staff, from the front desk, nurses/assistants, appt dest and PT crew are helpful and caring. Dr. Eby worked me in a day Dr. Cook was not in the office and was equally as caring and professional.

-Lynn S.
Lebanon, TN

When our daughter broke her arm I was amazed at the level of compassion from the moment we checked in to the day we got the cast removed! Thanks AOS!!

-Todd K.
Brentwood, TN

I am very well pleased with this group. I have visited four of their doctors for different things. Dr. Patel operated on my neck several years ago. Dr. Eby takes care of my back/leg pain. Dr. LaDouceur just operated on my hand. Great job, can't tell it was operated on. Dr. Passmore fixed my foot fracture. Finally physical therapy group was amazing. You can't go wrong with AOS.

-Carol A.
Mt. Juliet, TN

I absolutely love this place. They are always courteous and professional. You actually get a live person when you call in; and they get me in quick, no matter what my issue is. Dr. LaDouceur knew exactly what was wrong with my shoulder at my very first appointment. After struggling for 3 months I finally found a place that fixed my shoulder. The surgery was quick and they've been wonderful in following up with my progress. My son is also a patient here, and I wouldn't go anywhere else. The entire staff are warm and friendly at every visit.

-Dana S.
Nashville, TN

Dr. Passmore and the physical therapy staff are great. They've taken great care of me over the past few years and some of my other family members as well. I'd recommend them to anyone! Very smart, encouraging, hard-working group of doctors and therapists!

-Jesse T.
Old Hickory, TN

I have been treated always in a sweet and professional manner each time I have entered the office. The ladies are always friendly and willing to help in any way. Dr. Patel always takes time to explain any questions you may have. I will definitely return if I have another need.

-Sharon T.
Tennessee Ridge, TN

Dr. Cook is a wonderful doctor. His bedside manner is fantastic. he makes you feel like you are his only patient. My mother has had total hip replacement under his care. We couldn't be happier with our doctor.

-Michelle M.
Hermitage, TN

Every single staff member always treats me with kindness and compassion. The doctors are awesome! Would (and already have) recommend this facility to anyone. You will NOT regret it!

-Robin T.
Hermitage, TN

The doctors, PAs, and staff here are great. I have been a patient here for 20 years and the staff hasn't changed. This practice offers the same great care even as it merged and grew.

-Patty L.
Nashville, TN

Dr. Eby and his staff are great!!! Dr. Eby is always cheerful and helps me with my back and sciatica issues! I highly recommend him!

-Roseanne B.
Mt. Juliet, TN

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